Nutrient Regulation during Pregnancy, Lactation, and Infant Growth

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Aboriginal, Torres Strait Islander and other First Nations people are advised that this catalogue contains names, recordings and images of deceased people and other content that may be culturally sensitive. Book , Online - Google Books. Includes bibliographical references and index. Metabolism in pregnancy -- Congresses. Pregnancy -- Nutritional aspects -- Congresses. Lactation -- Nutritional aspects -- Congresses.

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In both studies, food supplementation of malnourished lactating mothers resulted in a small increase in infant milk intake. In another study in Indonesia, maternal supplementation during pregnancy improved infant growth rates, possibly by increasing breastmilk production. Should breastfeeding mothers take extra vitamins and minerals?

A diverse diet containing animal products and fortified foods will help ensure that the mother consumes enough micronutrients for both herself and her breastfeeding infant. If a diverse diet is not available, a micronutrient supplement may help. For example, in areas where vitamin A deficiency is common, it is currently recommended that all mothers take a single high-dose supplement of , international units 3 IU of vitamin A as soon as possible after delivery.

Studies have shown that such a supplement improves the vitamin A levels in the mother, in breastmilk, and in the infant. High doses of vitamin A are not recommended for women during pregnancy or later than eight weeks after delivery or later than six weeks if the mother is not breastfeeding because too much vitamin A may cause damage to the developing fetus. The levels of thiamin, riboflavin, vitamin B-6, vitamin B, iodine, and selenium in breastmilk are also affected by how much is in the food the mother eats. Additional calcium and iron, in particular, are often needed to protect maternal reserves.

This is the period of time after giving birth that the mother does not become pregnant due to the hormonal effects of breastfeeding. Studies show that this effect is greater when the infant suckles more frequently and is exclusively breastfed. Increasing the interval between births has benefits for the mother and her children. A related effect is lactational amenorrhea, the period of time after giving birth that the mother does not menstruate due to the same hormonal effects of breastfeeding. This is the basis for the lactational amenorrhea method LAM 4 of contraception.

There are many other benefits of breastfeeding for the mother. Breastfeeding immediately after delivery stimulates contraction of the uterus. This may help reduce loss of blood and risk of hemorrhage, a major cause of maternal mortality. There is good evidence that breastfeeding reduces the risk of ovarian and breast cancer and helps prevent osteoporosis. If all three criteria are met, the risk of pregnancy is less than 2 percent. Does breastfeeding affect the health of mothers with HIV? Although one study suggested that lactation accelerated progression to AIDS, later studies did not support this finding.

A study in Kenya comparing breastfeeding with artifical feeding reported that HIV-positive mothers who breastfed were at greater risk of death than those who used infant formula. This study has been criticized for various flaws in its methods and interpretation. Three subsequent attempts to verify the findings—in Tanzania, in South Africa, and in a pooled analysis of nine clinical trials—found no relationship between infant feeding pattern and the health of HIVpositive mothers.

Both HIV infection and lactation increase nutritional requirements. HIV-positive mothers who breastfeed need access to sufficient food of adequate quality to meet these increased nutritional needs and to protect their stores. They should be counseled about the health and nutritional effects of breastfeeding for themselves and their children. The main concern is the balance of risks and benefits of breastfeeding for the infant.

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What can programs do to support breastfeeding and maternal nutrition? Information presented in this FAQ has implications for the distribution of food in the household, the division of labor, and the delivery of services to women. Health care providers can help improve maternal nutrition by counseling women about breastfeeding, increased food intake, dietary diversification, work-load reduction, and family planning including delaying the first birth, birth spacing, and options for limiting family size.

For undernourished populations and populations displaced by war and natural disasters, the use of breastmilk substitutes can be particularly dangerous. The best solution is to feed the mother, not the infant, and to give her whatever support she needs for breastfeeding. Providing additional foods and fluids to the mother helps both mother and child. The time for intervention should not be limited to periods of pregnancy and lactation. Adequate nutrition is a cumulative process. The recommendations in the box on page 5 are suggested to improve the nutrition of adolescent girls and women of reproductive age.

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